Payment and Reimbursement
Winners & Losers
Integration & Doctor Experience
Critics and Societal Cost
BONUS: Random!
100
Who is entitled to health care in Germany?
All Germans and legal residents of Germany are entitled to healthcare! In fact it has become illegal not to be insured, and having some sort of medical insurance is thus a requirement when applying for a job.
100
What is the average percent of an employee’s income in Germany that goes towards their Sickness Fund?
14%
100
True or False: New health care plans will be required to cover preventative care, like depression screenings (Post-ACA)
True
100
What's a critique of the old health care system? (Pre-ACA)
The number of uninsured people, the paradox of excess and deprivation, not universal, the most costly system, competitive private insurance system, lack of medical homes, reliance on expensive technologies, insurance tied to employment...
100
What are some supports of the Pre-ACA health care system?
1. People with insurance benefit from well-trained medical medical personnel and state of the art medical technologies 2. Compared to other industrialized nations has the most funding for medical research 3. Highest complex cancer survival rates 4. Freedom choice
200
What is a "sickness fund"? (Germany)
Required insurance applies to those below a set income level and is provided through private non-profit "sickness funds" at common rates for all members. It cannot refuse membership and includes a wide variety of coverage
200
What percent of Germans are uninsured?
.2%
200
Name one barrier to mental health and substance abuse treatment. (Pre-ACA)
Social stigma, lack of insurance coverage, pre-existing conditions, lack of cultural consideration, expenses...
200
What are some cost-controls used by the ACA?
1. Health insurance companies are limited in the amount of money they can retain from premiums to cover overhead costs 2.Caps the amount of money employers can put toward health insurance premiums 3. Containing Medicare Advantage Costs 4. Accountable Care Organization
200
True or False: Until recently, there have been almost no copays or deductibles for medical visits.
True! Recently, Germans have begun paying €10 copays for prescription drugs, doctors visits, and hospital stays.
300
Which individual and group will see the highest peak in tax increases? (POST-ACA)
Individuals whose taxable income is more than $200,000, or married joint filers whose taxable income exceeds $250,000, face a 3.8 percent jump in the tax rate next year.
300
Of the 62% of bankruptcies in the US, which are caused by inability to pay medical bills, what percent of those had health insurance prior to their illness?
75%
300
What percentage of decrease in suicide rates has Germany seen in the last decade?
40%
300
What are some supporting reasons for the German health care system?
1. Universal Healthcare Coverage 2. Very few and low out-of-pocket costs 3. Generous Benefits 4. Healthcare expenditures have been stable for years
300
What percentage of US doctors abuse substances?
10-15%
400
True or False: Under no circumstance can the federal government withhold Medicare payments from hospitals under ACA.
False: The Affordable Care Act allows the federal government to withhold Medicare payments from hospitals if too many patients return within 30 days of discharge for certain ailments such as a heart attack or pneumonia.
400
What percentage of Americans receive their health insurance through their employer?
48%
400
In what decade did Germany turn towards community based mental health care?
1970s
400
What are some ways of controlling and lowering cost of health care in Germany?
1. Tax -financing controls: taxes used to regulate expenditures for healthcare which are earmarked. 2. Concerted Action:body made up of representatives of health providers, sickness funds, employers, unions, and diff levels of governments (p.172) (a) Global budgeting/expenditure caps for physician payments (b) Based off of guidelines from concerted action “negotiations are made at state, regional, and local levels between the sickness funds in a region, the regional physicians’ association, and the hospitals to set physician fees and hospital rates”(p.172). Also set guidelines pharmaceuticals and supplies. 3. Reforms in 2004: cost control measures to limit size of sickness fund
400
How are psychiatrists now compensated for each patient? (Germany)
Psychiatrists are paid based on the diagnosis and treatment they provided.
500
What was the goal of capitation (Pre-ACA)?
Under capitation, a doctor, medical group, hospital or integrated health system receives a certain flat fee every month for taking care of an individual enrolled in a managed health care plan, regardless of the cost of that individual's care (usually with a few exceptions built into the contract for unusual types of care).
500
How many states have opted out of Medicaid expansion?
21
500
Who pays for medical school in Germany?
State funds
500
What are some supporting arguments for the German health care system?
1. Universal Healthcare Coverage 2. Very few and low out-of-pocket costs 3. Generous Benefits 4. Healthcare expenditures have been stable for years
500
What is Chris Knoepke's middle name?
Emil
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